BACKGROUND: Antimicrobial resistance among bacteria pathogens is a world-wide issue. The antimicrobial susceptibility patterns of common pathogenic bacteria are essential to guide empirical and pathogen ... [more ▼]

BACKGROUND: Antimicrobial resistance among bacteria pathogens is a world-wide issue. The antimicrobial susceptibility patterns of common pathogenic bacteria are essential to guide empirical and pathogen-specific therapy; unfortunately, these data are scarse in Cameroon. OBJECTIVE: To determine the antimicrobial susceptibility patterns of Gram-negative bacilli isolated in Yaounde Central Hospital Laboratory of Bacteriology. METHODS: Gram-negative bacilli isolates (n = 505), obtained from a wide range of clinical specimens (urine, pus and blood) in Yaounde Central Hospital Laboratory of Bacteriology between March 1995 and April 1998, were evaluated for resistance to antibiotics (amoxicillin, amoxicillin/clavulanate, piperacillin, cefazolin, cefoxitin, cefotaxime, ceftazidime, aztreonam, imipenem, gentamicin, tobramicin, ofloxacin and trimethoprim/sulfamethoxazole) by the Kirby-Bauer disk diffusion method. RESULTS: High rates of resistance were found in most of the bacteria studied. Resistance to all isolates was mostly observed for amoxicillin (87%), piperacillin (74%) and trimethoprim/sulfamethoxazole (73%). Susceptibilities to third generation cephalosporins (cefotaxime, ceftazidime) and monobactame (aztreonam) were = 91% for Escherichia coli, = 71% for Klebsiella spp., = 98% for Proteus mirabilis, = 50% for Enterobacter spp. and Citrobacter spp. Pseudomonas aeruginosa was less susceptible to cefotaxime (2%) and aztreonam (33%), and highly susceptible to ceftazidime (72%) whereas Acinetobacter baumannii was highly resistant to aztreonam (100%), to cefotaxime (96%) and cetazidime (62%). Imipenem (98%) was the most active antibiotic followed by the ofloxacine (88%). Susceptibility of all isolates to gentamicin was 67%. CONCLUSION: These results indicate that surveillance to antimicrobial resistance in Cameroon is necessary to monitor microbial trends, antimicrobial resistance pattern, and provide information for choosing empirical or direct therapy to physicians. [less ▲]

CTX-M-15-producing Klebsiella pneumoniae and Escherichia coli emerged recently in Cameroon. CTX-M-15 was encoded by two different multiresistance plasmids, of which one carried an ISEcp1-bla(CTX-M-15 ... [more ▼]

CTX-M-15-producing Klebsiella pneumoniae and Escherichia coli emerged recently in Cameroon. CTX-M-15 was encoded by two different multiresistance plasmids, of which one carried an ISEcp1-bla(CTX-M-15) element flanked by a 5-bp target site duplication and inserted within a Tn2-derived sequence. A truncated form of this element in the second plasmid was identified. [less ▲]

Organisms producing extended-spectrum beta-lactamases (ESBLs) have been reported in many countries, but there is no information on the prevalence of ESBL-producing members of the family Enterobacteriaceae ... [more ▼]

Organisms producing extended-spectrum beta-lactamases (ESBLs) have been reported in many countries, but there is no information on the prevalence of ESBL-producing members of the family Enterobacteriaceae in Cameroon. A total of 259 Enterobacteriaceae strains were isolated between 1995 and 1998 from patients at the Yaounde Central Hospital in Cameroon. Enterobacterial isolates resistant to extended-spectrum cephalosporin and monobactam were screened for ESBL production by the double-disk (DD) synergy test. Thirty-one (12%) of these Enterobacteriaceae strains were shown to be positive by the DD synergy test, suggesting the presence of ESBLs. Resistance to oxyimino-cephalosporins and monobactams of 12 (38.7%) of the 31 strains-i.e., 6 Klebsiella pneumoniae, 4 Escherichia coli, 1 Citrobacter freundii, and 1 Enterobacter cloacae strain-was transferred to E. coli HK-225 by conjugation. Resistance to gentamicin, gentamicin plus trimethoprim-sulfamethoxazole, or trimethoprim-sulfamethoxazole was cotransferred into 6, 2, and 1 of these transconjugants, respectively. All 12 transconjugants were resistant to amoxicillin, piperacillin, all of the cephalosporins, and aztreonam but remained susceptible to cefoxitin and imipenem. Crude extracts of beta-lactamase-producing transconjugants were able to reduce the diameters of inhibition zones around disks containing penicillins, narrow- to expanded-spectrum cephalosporins or monobactams when tested against a fully susceptible E. coli strain but had no effect on such zones around cefoxitin, imipenem, and amoxicillin-clavulanate disks. The beta-lactamases produced by the 12 tranconjugants turned out to be SHV-12 by DNA sequencing. Therefore, the ESBL SHV-12 is described for the first time in Cameroon. [less ▲]